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[[Category: Drugs]] [[Category:Glutamate receptor antagonist ]]
[[Category: Drugs]][[Category: NMDA receptor antagonist]]


==Introduction==
[[:Category: Antidementia Drug | '''Antidementia Drug''']]
Memantine, is a glutamate receptor antagonist. It is used to treat moderate to
severe Alzheimer’s disease.


'''Drug class: [[:Category: NMDA receptor antagonist | NMDA Receptor Antagonist]]'''


'''Memantine (EBIXA)''' (中文:[[美金剛]])
==Common Strengths of Memantine==
* 10 mg, 20 mg
==Drug Trade Names==
*Ebixa
==Drug Usage==
Memantine is primarily used in the treatment of moderate to severe Alzheimer's disease.
==Mechanism of Action==
Memantine blocks the NMDA receptors in the brain, which are activated by glutamate. This action helps prevent excessive neuronal excitability and protects against excitotoxicity, which can lead to neuronal death. Unlike complete antagonist, memantine allows for normal synaptic transmission at physiological levels of glutamate.
==Route of Administration==
*Oral tablet
==Dosages==
*Start at 5 mg once daily, increasing to a maximum of 10 mg twice daily.
==Side Effects==
{| class="wikitable"
{| class="wikitable"
!Generic Name 藥名
!style="text-align: left"| Frequency
!HA Code 藥物代碼
!Adverse reactions
!Classification藥物分類
|-
| rowspan="5" | '''Common Side Effects
| Dizziness
|-
| Confusion
|-
| Headache
|-
| Constipation
|-
| Diarrhea
|-
| rowspan="3" | '''Serious Side Effects
| Hallucinations
|-
|-
|Memantine HCL Tablet 10mg
| Severe allergic reactions (e.g. difficulty breathing)
|MEMA01
|-
|P1S1S3
| Shortness of breath
|}
|}


==Mechanism of Action==
==Pharmacokinetics==
Glutamate receptor antagonist
*Memantine undergoes minimal metabolism, primarily in the liver. It is not significantly affected by cytochrome P450 enzyme, which reduces the potential for drug interactions.
*Excretion: Approximately 57% to 82% of memantine is excreted unchanged in urine.
*Half-Life: The terminal elimination half-life ranges from 60 to 80 hours, allowing for once-daily dosing in clinical settings.
*Onset Time: Typically, within hours after administration.
*Duration: Effects can last up to 24 hours.
 
==Drug Precautions==
'''Pregnancy
 
The safety of memantine during pregnancy has not been firmly established.
 
'''Breastfeeding


The effects of memantine during breastfeeding are also unknown; thus, caution is advised.


==Dosage==
'''Children and Elderly
*Children: Safety and efficacy have not been established in pediatric populations.
*Elderly: Dosage adjustments may be necessary due to increased sensitivity and potential renal impairment.


By Oral: initially 5 mg once daily, increased in steps of 5 mg at weekly intervals to a maximum dose of 20 mg daily.
'''Drug Monitoring Items


Clinical benefit should be assessed on a regular basis.  
Monitoring should include:
*Renal function (eGFR)
*Neurological status (cognition and behavior changes)
*Side effects such as dizziness, constipation, headache, and drowsiness. Serious adverse effects such as confusion or hallucinations should prompt immediate reevaluation of the treatment plan


'''Drug Interactions


=Side Effects==
Memantine can interact with several medications, leading to increased side effects or reduced effectiveness. Key interactions include:
*NMDA Antagonists: Co-administration with other NMDA antagonists such as amantadine and dextromethorphan (cough suppressant) should be approached with caution, as they may enhance the adverse reaction associated with memantine.
*Antacid: Certain antacids containing sodium bicarbonate can alter the excretion of memantine, potentially increasing its levels in the body.
*Warfarin: There is a caution regarding the concurrent use of warfarin, a blood thinner, due to potential alterations in its effectiveness when combined with memantine.


Common side effects include
==FAQ==
*Constipation
'''How Should I Take the Tablet?
*Dizziness
*Headache
*Hallucinations
*confusuion
*sleepiness


Serious side effects may include:
It can be taken with or without food.
*Blood clots
*Psychosis
*Heart failure


==Pharmacokinetics==
'''What Should I Avoid While Taking?


{| class = "wikitable"
Avoid alcohol and medications that can affect kidney function without consulting your healthcare provider. Additionally, avoid taking other NMDA antagonists concurrently.
!style="text-align: left"| Oral bioavailability
|Memantine is well absorbed after oral doses. It is about 45% bound to plasma proteins.
|-
!style="text-align: left"| Onset of action
|Peak plasma concentrations are achieved in 3 to 8 hours
|-
!style="text-align: left"| Metabolism
|Partial hepatic metabolism.
|-
!Elimination half-life
|Ranges from 60 to 100 hours
|}


'''What Happens if I Miss a Dose?


How long does it take for donepezil to take effect?
If you miss a dose, take it as soon as you remember unless it is almost time for your next dose. Do not double up on doses.
Donepezil may take as long as 12 weeks to begin working.
What time of day should donepezil be taken?
It is usually taken once a day with or without food, just before bedtime. Take donepezil at around the same time every day.
Why is donepezil taken at night?
Donepezil is taken at night because it can cause irregular or slow heartbeat for some patients, which can cause fainting. When it is taken at bedtime, affected patients will be able to sleep through those side effects.

Latest revision as of 03:13, 7 November 2024


Antidementia Drug

Drug class: NMDA Receptor Antagonist

Memantine (EBIXA) (中文:美金剛)

Common Strengths of Memantine[edit]

  • 10 mg, 20 mg

Drug Trade Names[edit]

  • Ebixa

Drug Usage[edit]

Memantine is primarily used in the treatment of moderate to severe Alzheimer's disease.

Mechanism of Action[edit]

Memantine blocks the NMDA receptors in the brain, which are activated by glutamate. This action helps prevent excessive neuronal excitability and protects against excitotoxicity, which can lead to neuronal death. Unlike complete antagonist, memantine allows for normal synaptic transmission at physiological levels of glutamate.

Route of Administration[edit]

  • Oral tablet

Dosages[edit]

  • Start at 5 mg once daily, increasing to a maximum of 10 mg twice daily.

Side Effects[edit]

Frequency Adverse reactions
Common Side Effects Dizziness
Confusion
Headache
Constipation
Diarrhea
Serious Side Effects Hallucinations
Severe allergic reactions (e.g. difficulty breathing)
Shortness of breath

Pharmacokinetics[edit]

  • Memantine undergoes minimal metabolism, primarily in the liver. It is not significantly affected by cytochrome P450 enzyme, which reduces the potential for drug interactions.
  • Excretion: Approximately 57% to 82% of memantine is excreted unchanged in urine.
  • Half-Life: The terminal elimination half-life ranges from 60 to 80 hours, allowing for once-daily dosing in clinical settings.
  • Onset Time: Typically, within hours after administration.
  • Duration: Effects can last up to 24 hours.

Drug Precautions[edit]

Pregnancy

The safety of memantine during pregnancy has not been firmly established.

Breastfeeding

The effects of memantine during breastfeeding are also unknown; thus, caution is advised.

Children and Elderly

  • Children: Safety and efficacy have not been established in pediatric populations.
  • Elderly: Dosage adjustments may be necessary due to increased sensitivity and potential renal impairment.

Drug Monitoring Items

Monitoring should include:

  • Renal function (eGFR)
  • Neurological status (cognition and behavior changes)
  • Side effects such as dizziness, constipation, headache, and drowsiness. Serious adverse effects such as confusion or hallucinations should prompt immediate reevaluation of the treatment plan

Drug Interactions

Memantine can interact with several medications, leading to increased side effects or reduced effectiveness. Key interactions include:

  • NMDA Antagonists: Co-administration with other NMDA antagonists such as amantadine and dextromethorphan (cough suppressant) should be approached with caution, as they may enhance the adverse reaction associated with memantine.
  • Antacid: Certain antacids containing sodium bicarbonate can alter the excretion of memantine, potentially increasing its levels in the body.
  • Warfarin: There is a caution regarding the concurrent use of warfarin, a blood thinner, due to potential alterations in its effectiveness when combined with memantine.

FAQ[edit]

How Should I Take the Tablet?

It can be taken with or without food.

What Should I Avoid While Taking?

Avoid alcohol and medications that can affect kidney function without consulting your healthcare provider. Additionally, avoid taking other NMDA antagonists concurrently.

What Happens if I Miss a Dose?

If you miss a dose, take it as soon as you remember unless it is almost time for your next dose. Do not double up on doses.